Diabetes Management Self-Efficacy Research Articles

Combining CGM and an Online Peer Support Community for Hispanic Adults with T2D: A Feasibility Study.

Previous research has identified that people with type 2 diabetes (T2D) within the Hispanic community would benefit from an online peer support community (OPSC) and continuous glucose monitoring (CGM) data to facilitate diabetes self-management. A mixed-methods feasibility study enrolled Hispanic, Spanish-speaking adults with T2D, not on insulin. Participants were provided with CGM and access to an OPSC for 12 weeks. Feasibility was assessed by number of eligible participants who enrolled, attrition, quantity of CGM data, validated clinical measures of self-efficacy, quality of life and adverse events. Engagement in the OPSC was measured using objective metrics on the online platform. Qualitative interviews were conducted upon conclusion of the intervention to assess feasibility, acceptability, participant satisfaction, and key recommendations for improvement. Of 46 participants screened, 39 were eligible and 26 completed the study. Participants significantly improved self-efficacy scores. Posts in the OPSC related to goal setting had the highest engagement followed by mid-week and end of week check-in posts respectively. Participant interviews described challenges accessing the OPSC platform as a barrier to engagement. Despite this, all participants were satisfied with the intervention. Key recommendations for improvement included providing greater variety of and individualized education and the use of a peer support platform that is easily accessible. The CGM + OPSC intervention tailored to the Hispanic community with T2D was feasible, acceptable and satisfactory and improved participant self-efficacy for diabetes management which may lead to improved clinical outcomes.

Positioning the Registered Dietitian for Culinary-Centric Research

Describe strategies and methodologies to plan, implement and assess culinary medicine initiatives. Interest and engagement in culinary medicine has steadily grown across multiple sectors, disciplines and settings over the past several years. Despite Registered Dietitians (RDs) being extremely well-positioned for leading culinary medicine initiatives, curriculum development, programming and intervention implementation, these initiatives frequently lack the leadership and expertise of RDs. Furthermore, there is a consistent absence of research and data collection to assess the feasibility and efficacy of these culinary medicine initiatives. The Diabetes Inspired Culinary Education (DICE) program was an RD-developed community-based culinary medicine research intervention to improve the dietary intake and disease management of children with type 1 diabetes. The program included ten, 90-minute lessons delivered weekly by two RDs, dietetic interns and undergraduate dietetics students at a community teaching kitchen. The program included hands-on, age-appropriate culinary education, nutrition and diabetes education delivered through experiential learning, a group family meal prepared by participating youth and culinary/mealtime goal-setting. Baseline and post-test outcomes were assessed on participating families at the child-level (food preparation self-efficacy (SE), involvement, attitude; dietary intake; diabetes management; diabetes quality of life; hgbA1c; BMI), primary caregiver-level (dietary intake; diabetes management SE; mealtime SE; BMI) and family-level (family food preparation; mealtime environment). Feasibility was evaluated using participant attendance, retention and a program-specific fidelity tool. The program represents a reproducible, evidence-based approach for integrating dietitian-led research in a culinary-centric methodology.

Visual Impairment and Self-Efficacy in Diabetes Management.

The purpose of this study is to examine the relationship between visual impairment and diabetes management self-efficacy. The present study utilized pooled cross-sectional data (2008-2018) from the Medical Expenditure Panel Survey Household Component and Diabetes Care Survey. Binary and generalized ordinal logit regression models were used to compare diabetes management self-efficacy between patients with and without visual impairments. Compared to their non-visually impaired counterparts, visually impaired persons had a lower odds of reporting high diabetes management self-efficacy. Similarly, visually impaired adults with diabetes have a significantly lower odds of being very confident in their ability to manage their conditions compared with adults who reported being not confident, somewhat confident, or confident. Several control factors, including self-behaviors and receipt of diabetes self-management education (DSME), were also associated with diabetes management self-efficacy. Visually impaired persons experience significant disparities in diabetes management self-efficacy. Given the relationship between self-efficacy and diabetes-related outcomes, it is crucial that DSME be tailored to effectively meet the individual needs of this population. Future research should explore the relationship between DSME and self-care behaviors, self-efficacy, and diabetes-related outcomes in visually impaired persons.

Self-Efficacy Effects of Maccabi Telcare Center Diabetes Mellitus Intervention: Do Men and Women Benefit Equally?

A growing body of evidence points to physiological and psychological gender differences in the manifestation and treatment of type 2 diabetes mellitus. This study is part of a large-scale, prospective trial investigating the effects of Maccabi Telecare Center (MTC) interventions on self-efficacy. Here, we focus on the effects of gender on diabetes self-efficacy related to depressive symptom severity and illness representation. A prospective open-label study investigating the effect of tele-based intervention on diabetes self-efficacy. Participants completed the following questionnaires: Diabetes Management Self-Efficacy Scale (DMSES) (self-efficacy), Patient Health Questionnaire 9 (PHQ-9) (depression), and Illness Perception Questionnaire-Revised (IPQ-R) (illness representation). Data were collected at three time points: Baseline (T1), 3-4 months (T2), and 8-9 months (T3). Although men and women exhibited similar baseline self-efficacy levels, men scored significantly higher than women over time, at T2 (p < .05) and T3 (p < .05). Consistent gender differences were observed throughout the study in depression and illness representations: women scored higher than men on PHQ-9 (3.94 vs. 5.57, p < .001), and perceived their diabetes consequences as more severe than men (p < .001). A linear regression analyses indicated that MTC intervention, age, baseline self-efficacy, and depression at T3 explained 39.8% of the variance of selfefficacy at the conclusion of the study for both genders, although more strongly for men. This study indicates that the effects of a treatment intervention for individuals with type 2 diabetes mellitus are gender specific. Thus, gender-tailored interventions may be advised to further improve outcomes for women with type 2 diabetes mellitus.

Pengaruh Self-Efficacy Enhancing Intervention Program (SEEIP) Secara Online Terhadap Self-Efficacy Dalam Manajemen Diri Penderita Diabetes Mellitus Tipe II Di Puskesmas Juli I

Objective: The objective of this study was to determine the effect of Self-Efficacy Enhancing Intervention Program (SEEIP) with online method on Self-Efficacy in Self-Management in Type 2 Diabetes Mellitus (T2DM) at Juli I Public Health CentreMethods: This study was a pre-experimental pre-test and post-test with only one group design. The population wasT2DM at Juli I Public Health Center in 2020. The sample size was 22 participants, selected by purposive sampling technique. Diabetes Management Self-Efficacy Scale (DMSES) was used to measure the Self-Efficacy in Self- Management of T2DM patients. Data were analyzed using paired t-testResults: The results of the study showed that the means score of Self- Management of T2DM before receiving SEEIP was 39,00 (SD: 15,455) and 90,23 (SD: 7,571)after receiving the SEEIP. Paired t-test showed that there was a significant difference on Self- Efficacy in Self-Management in T2DM at Juli I Public Health Centre in 2020Conclusion: SEEIP could improve self-efficacy in self-management for Type 2 diabetes mellitus at Juli I Public Health Centre.

907-P: Diabetes-Inspired Culinary Education (DICE): An Innovative Approach to Type 1 Diabetes Management through Culinary Medicine

Despite the critical role nutrition plays in T1DM management and growth/development, youth with TIDM consistently have poorer diet qualities compared with their healthy counterparts. While culinary medicine is an area of research that is still in its infancy, initial studies have demonstrated success in improving youth diet quality and dietary and disease management outcomes in individuals with T2DM. Yet despite its great potential to elicit positive behavior change among youth with T1DM, this area of research is under-explored. Therefore, Diabetes Inspired Culinary Education (DICE), a community-based culinary medicine program aiming to improve diet quality and disease management among 6-14 year old youth with T1DM, was developed and assessed for feasibility and potential efficacy in a pilot study. The DICE program included ten, 90-minute lessons delivered weekly at a community teaching kitchen and included: hands-on, age-appropriate culinary education; nutrition and diabetes education delivered through experiential learning; a group family meal prepared by participating youth; and culinary/mealtime goal-setting. Baseline and post-test outcomes were assessed on participating families at the child- (food preparation self-efficacy (SE), involvement, attitude; dietary intake; diabetes management; diabetes quality of life; hgbA1c; BMI), primary caregiver- (dietary intake; diabetes management SE; mealtime SE; BMI) and family-level (family food preparation; mealtime environment). Feasibility was evaluated using participant attendance, retention and a program-specific fidelity tool. Eleven families were recruited and 8 completed (73% retention) the program. On average, 78% of participating families attended weekly lessons. Improvements in primary caregiver SE for healthy mealtime behaviors (p=0.02) and family food preparation (p=0.05) were observed at post-test, inferring potential program efficacy. Disclosure C. R. Mcmanus: None. H. Barkoukis: None. R. Kim: None. J. Nguyen: None.

Correlation Between Functional Health Literacy and Self-efficacy in People with Type 2 Diabetes Mellitus: Cross-sectional Study.

To analyze the correlation between functional health literacy (FHL) and self-efficacy (SE) in people with type 2 Diabetes Mellitus. Cross-sectional study was conducted among September and October 2019, with 196 people with type 2 diabetes. Data were collected using the Functional Literacy in Health instrument (B-TOFHLA) and the Diabetes Management Self-Efficacy Scale for Patients with Type 2 Diabetes Mellitus (DMSES). Bivariate analysis was used to verify the relationship among the constructs. Most diabetics showed an average B-TOFHLA score of 74.75, considered adequate, and self-efficacy of 4.07, high. The association between SE and FHL in the bivariate analysis found no statistical significance (p > .05), in the same sense as the B-TOFHLA score and the DMSES domains (p > .05). Constructs were not related to each other in terms of skills arising from judgments and decisions with motivational confidence by the investigated audience.

The self-efficacy improvement in adolescent girls with type 1 diabetes mellitus with self-care education through mobile-based social networking

Type 1 diabetes mellitus (T1DM) is the most common chronic metabolic disease in childhood and adolescence. The increasing use of social networks among adolescents provides a unique opportunity to implement self-care educational programs for improving self-efficacy in diabetic adolescents in terms of awareness, attitude, and performance. This study aimed to assess the effectiveness of a self-care educational program provided by mobile-based social networking (MBSN) on the self-efficacy of diabetic adolescent girls. A quasi-experimental study with 76 Iranian 14- to 18-year-old girls with T1DM was conducted in 2018–2019. The subjects were selected with aconvenient sampling method and randomly assigned to the experimental and control groups. The MBSN was applied to implement a self-care educational program in the experimental group for 12 weeks. The Diabetes Management Self-Efficacy Scale (DMSES) questionnaire with the main domains of blood sugar control (BSC), diet control (DC), medical care (MC), and exercise was used to evaluate the self-efficacy level before and 4 weeks after the intervention. The mean age and T1DM duration of participants were 15.9 ± 1.5 and 7.24 ± 3.9 years, respectively. No significant difference in the self-efficacy of the two groups before the intervention was found. The self-efficacy level in the experimental group was increased after the intervention so that there was a significant difference in this parameter between the experimental and control groups (p < 0.0001). Three DMSES domains of BSC (p = 0.003), DC (p = 0.011), and MC (p = 0.016) after the intervention significantly differed between the two groups. As the self-care education with MBSN significantly increased the self-efficacy level of girls with T1DM, this technique would be a complementary of health care in educating and supporting diabetic patients in other age groups.

Effectiveness of an adapted diabetes nutrition education program on clinical status, dietary behaviors and behavior mediators in adults with type 2 diabetes: a randomized controlled trial.

This study evaluated the effectiveness of an adapted social-cognitive theory underpinned diabetes nutrition education program (NEP) on: clinical (HbA1c, BMI, blood lipids, blood pressure) and selected dietary behaviors (starchy foods and energy intake, vegetables and fruit intake) and behavior mediators (knowledge and diabetes management self-efficacy) in patients with type 2 diabetes mellitus (T2DM). A tertiary hospital outpatient adults (40-70years) with poorly controlled (HbA1c ≥ 8 %) T2DM were randomized to either intervention group (n = 39: NEP, 7-monthly group education sessions, bi-monthly follow-up sessions, 15-minute individual session, workbook + education materials) or control group (n = 38: education materials only). NEP aimed to improve clinical status through improved dietary behaviors and behavior mediators. Outcomes and changes in diabetes medication were assessed at six and 12months. Intention-to-treat analysis was conducted. ANCOVA compared the groups (baseline values, age, sex adjustments). Forty-eight (62.3 %) participants completed the study. Intervention group compared to the control group had lower (-0.53 %), clinically meaningful HbA1c (primary outcome) at 6 months, albeit not sustained at 12 months. Compared to the control group, the intervention group had significantly lower: (i) systolic blood pressure at six and 12 months (ii) diastolic pressure at 12 months, (iii) energy intake at six-months, (iv) up-titration of insulin at six and 12 months and higher diabetes knowledge scores at six months. NEP had limited effects on HbA1c, targeted dietary behaviors and behavior mediators but showed positive effects on blood pressure. The NEP health cost savings potential supports the need for improving program participation. ClinicalTrials.gov. number NCT03334773; 7 November 2017 retrospectively registered.

Impact of diabetes self-management, diabetes management self-efficacy and diabetes knowledge on glycemic control in people with Type 2 Diabetes (T2D): A multi-center study in Thailand.

We investigate the relationship of diabetes knowledge, diabetes management self-efficacy and diabetes self-management with blood glucose control among people with Thai type 2 diabetes mellitus (T2D). Seven hundred outpatients from diabetes clinics from large university and small community hospitals in two provinces of Thailand (Khon Kaen and Bangkok) were interviewed to evaluate their diabetes knowledge (DK), diabetes management self-efficacy (DMSE) and diabetes self-management (DSM). In addition, patient medical records were accessed to obtain other patient characteristics including patients' HbA1c levels. Bivariate and multivariable logistic regression modelling was conducted and unadjusted and adjusted odds ratios obtained, respectively. Over half (52.4%) of the patients in our sample failed to control their blood glucose (HbA1c > 7%). All three psychometric measures (DK, DMSE and DSM) were identified as associated with blood glucose control in the bivariate analysis (ORDK(unadj) = 0.89, 95%CI: 0.82, 0.96; ORDSM(unadj) = 1.64, 95%CI: 1.46, 1.82; ORDMSE(unadj) = 2.84; 95%CI: 2.43, 3.32). However, after mutual adjustment and adjustment for other patient characteristics, of the three psychometric measures, only diabetes management self-efficacy remained associated with blood glucose control (ORDMSE(adj) = 2.67; 95%CI: 2.20, 3.25). Diabetes management self-efficacy is shown to be strongly associated with blood glucose control in the Thai Type 2 diabetes population. Current early diabetes interventions in Thailand tend to focus on disease knowledge. A stronger emphasis on enhancing patients' disease management self-efficacy in these interventions is likely to lead to substantial improvement in both diabetes self-management and blood glucose control, thereafter reducing the risk, or prolonging the development, of chronic diabetes complications.

Examination of the relationship of knowledge of diabetes, attitude toward diabetes, and health literacy with diabetes management self-efficacy using hierarchical multiple regression modeling

Background. Self-efficacy in diabetes management can empower patients and result in their more active participation in the treatment process. In addition, a patient’s behavior is influenced by their knowledge of and attitude toward their illness. Therefore, the goal of the present study was to examine the association of knowledge of diabetes, attitude toward diabetes, and health literacy with diabetes management self-efficacy in patients with type 2 diabetes. Methods. This descriptive-correlational study was conducted in 2019. The sample included 115 patients with diabetes (59 women and 56 men) attending diabetes centers of Sanandaj, Kurdistan, Iran, who were selected using a convenience sampling method. The Brief Diabetes Knowledge Test (DKT), the Diabetes Attitude Scale (DAS), the Health Literacy for Iranian Adults (HELIA) scale, and the Diabetes Management Self-Efficacy Scale (DMSES) were used to gather data. The data was analyzed using descriptive statistics, Pearson correlation coefficient, and stepwise regression analysis. All the analyses were perfumed using SPSS, version 16. The significance level was set at 0.05 for all the tests. Results. The mean age of participants was 46.61 ± 13.73 years. Health literacy (r = 0.585) and attitude (r = 0.396) were significantly correlated with self-efficacy (P = 0.001). According to the results of stepwise regression analysis, 34.3% and 36.6% of the variance of self-efficacy was explained by health literacy alone and health literacy together with attitude, respectively. One standard deviation change in health literacy and attitude was associated with 0.51 and 0.71 standard deviation change in self-efficacy, respectively. Conclusion. Health literacy and attitude toward diabetes are positively associated with self-efficacy in diabetes management, and improving these variables can improve self-efficacy in patients with type 2 diabetes.

Effects of the Information–Motivation–Behavioral Skills Model on Metabolic Control of Adolescents with Type 1 Diabetes in Turkey: Randomized Controlled Study

PurposeTo evaluate the effects of information–motivation–behavioral skills model interventions given by nurses during home visits on the knowledge levels, personal and social motivation levels, behavioral skills, and HbA1C levels of adolescents with poor glycemic control. Design and methodsThe present study was designed as randomized controlled trial. 50 adolescents with type 1 diabetes were equally divided into study and control groups. Socio-Demographic Form, Diabetes Information Evaluation Form, The Child Attitude Toward Illness Scale, The Multidimensional Scale of Perceived Social Support, and Diabetes Management Self-Efficacy Scale were utilized in data collection. The scales were administered at the beginning of the study and six months later. HbA1c levels of adolescents were evaluated in the third and sixth months. Multiple home visits and phone calls were made to each participant in the intervention group. Interventions to improve the information–motivation–behavioral skills model-based knowledge, personal and social motivation, and behavioral skills were applied during the home visits. ResultsAs a result of information–motivation–behavioral skills model-based interventions, knowledge levels (p<0.001), personal motivation levels (p = 0.001), social motivation levels (p = 0.004), and behavioral skills (p<0.001) of the study group improved. Additionally, HbA1c levels decreased significantly in the third (p<0.001) and sixth months (p<0.001). ConclusionInformation-Motivation-Behavioral Skills Model-based intervention effectively improved glycemic control among adolescents with type 1 diabetes. Practice implicationsNurses should develop strategies to increase personal motivation, social motivation, and behavioral skills to training programs planned for adolescents with type 1 diabetes.

GAMBARAN SELF EFFICACY PADA PASIEN DIABETES TIPE 2 DI POLIKLINIK PENYAKIT DALAM RSUPN DR. CIPTO MANGUNKUSUMO JAKARTA

Self-efficacy is an individual's assessment of the ability to complete a given task. Diabetes self-efficacy is required to improve the outcome of diabetes management. This study aims to assess the ability of self-efficacy in diabetic patients using Diabetes Management Self Efficacy (DMSE). The research design used is descriptive method. The study was conducted at the Internal Medicine Polyclinic of Cipto Mangunkusumo Hospital Jakarta with 60 samples of type 2 diabetes patients using consecutive sampling technique. The measuring instruments used were demographic characteristics and Diabetes Management Self Efficacy (DSME). The results showed the characteristics of the respondents in the study were 57% women, the highest education was high school respondents (33%), the most complications were diabetic retinopathy (38%). Based on the mean age of type 2 diabetes respondents, namely 57.60 years, the average length of diabetes was 11.40 years, and the mean self-efficacy score was 59.0. Assessment of self-efficacy using DMSE can be used to assess self-efficacy in type 2 diabetes, so that it can make it easier for nurses to educate and counsel patients with type 2 diabetes related to self-efficacy so that it can improve selfmanagement in type 2 diabetes patients.

Evaluation of the effectiveness of Persian diabetes self-management education in older adults with type 2 diabetes at a diabetes outpatient clinic in Tehran: a pilot randomized control trial.

The effectiveness of diabetes self-management interventions has been more generally demonstrated in adults, but there is little evidence of diabetes self-management specific to older adults situated in Iran. The purpose of this study was to evaluate the effectiveness of Persian Diabetes Self-Management Education on self-efficacy, quality of life, self-care activity, depression and loneliness in older adults with type 2 diabetes. In pilot randomized controlled trial, a total of 34 participants ≥60years with type 2 diabetes were randomly assigned into intervention (n = 17) and control (n = 17) group in an outpatient diabetes clinic in Tehran. To assess the primary outcome of participant experiences, the Diabetes Management Self-efficacy Scale (DMSES) was the method of measurement. The Diabetes Quality of Life-Basic Clinical Inventory (DQoL-BCI), Patient Health Questionnaire-9 (PHQ-9), Diabetes Self-Management Education Scale (DSMES), and adult Social-Emotional Loneliness Scale Short form (SELSA-S) were used as secondary outcomes. Participants' evaluations were completed at baseline, while measurements were conducted two and four weeks after allocation, using repeated measurements of Univariate and multivariate ANOVA (adjusted for baseline values) to analyze the data. In the multivariate model, there was a significant difference between the control and intervention groups regarding reported quality of life (p = 0.04) and the medical-domain's reported self-efficacy (p = 0.02). However, there were no significant differences in the reported self-management, depression, loneliness, as well as the other domain of self-efficacy; as compared between the two groups before and after intervention. The study depicts a promising impact on older adults, imparted by the pertinent program. The finding showed PDSME has a positive effect on quality of life and medical control domain of self-efficacy. This pilot study showed that the program is feasible and duly beneficial if delivered to older adults. This pilot proves appealing to begin further testing within a larger sample population.

The Influence of Self-management Knowledge and Distress on Diabetes Management Self-efficacy in Type 2 Diabetes Patients

The Influence of Self-management Knowledge and Distress on Diabetes Management Self-efficacy in Type 2 Diabetes Patients

Illness perceptions as a mediator between emotional distress and management self-efficacy among Chinese Americans with type 2 diabetes

ABSTRACT Objectives: Emotional distress and illness perceptions have been linked to patients’ self-efficacy for diabetes management. This study, guided by Leventhal’s Self-Regulatory Model, explores the direct effects of emotional distress (diabetes distress and depressive symptoms) on diabetes management self-efficacy, and the indirect effects through illness perceptions among Chinese Americans with type 2 diabetes (T2DM). Design: Data were obtained from a cross-sectional study of Chinese Americans with T2DM recruited from health fairs and other community settings (N = 155, 47.1% male, mean age 69.07 years). Data analyses including descriptive statistics, correlation, and PROCESS mediation models were used to examine the mediation effects of illness perceptions. Results: Diabetes distress and depressive symptoms had direct negative effects on self-efficacy. Perceived treatment control mediated the association between diabetes distress and self-efficacy, while none of the illness perceptions dimensions impacted the relationship between depressive symptoms and self-efficacy. Conclusion: Improved perceptions of treatment control can ameliorate diabetes distress and improve diabetes management self-efficacy among Chinese Americans. Health providers should elicit patients’ illness perceptions as a first step in evaluating their diabetes management self-efficacy and provide appropriate culturally-tailored interventions.

Effect of Self-Management Program on Self-efficacy regarding Osteoporosis Risk among Diabetic Patients

Background: Prevalence of osteoporosis is high among diabetes patients. Assessment of self-efficacy regarding osteoporosis risk as well as patient education should be included as part of the self-management of diabetes. Aim:To evaluate the effect of a self management program on self-efficacy regarding osteoporosis risk among diabetic patients. Methods:A quasi-experimental (pre-posttest) research design was conducted on 90 diabetic patients who admitted in the internal medicine department at Assiut university hospital. Data were collected via pre-postintervention and at 3-month follow-up.Patient assessment sheet, Demographic and medical data, the new One-Minute osteoporosis risk test, and Diabetes Management Self-Efficacy Scale (DMSES) were used. Results:The majority of participants had moderate osteoporosis risk. There was a significant improvement in self-efficacy after self-care management program application.There was a statistically significant difference between diabetes management self-efficacy scores and the new one-minute osteoporosis risk test levels. Conclusion:A positive effects of self-care management regarding osteoporosis among studied patients with diabetes on self-efficacy scores.Recommendations:Relevant forms and visual information to facilitate educating diabetic patients regarding osteoporosis ought to be accessible and given to each diabetic patient.

The effect of metabolic control, self-efficacy, and quality of life on emotional eating in the adolescents with type 1 diabetes mellitus

The purpose was to investigate the effects of metabolic control, self-efficacy, and quality of life on emotional eating in the adolescents with type 1 diabetes mellitus. This was a descriptive, cross-sectional, and correlational study. A total of 107 adolescents participated. Data were collected using the Pediatric Quality of Life Inventory™ 3.0 Diabetes Module, the Diabetes Management Self-Efficacy Scale, and the Emotional Eating Scale. The relationships among emotional eating, metabolic control, self-efficacy, and quality of life were assessed using bivariate correlation analyses. Multiple regression analysis was used to analyze the data. The adolescents with diabetes ranged in age from 11 to 18 years. The mean duration of diabetes was 5.42 ± 3.35 years. Mean A1C levels were 9.29 ± 1.38%, far above the recommended level. When the correlation between emotional eating and self-efficacy was studied in the adolescents, there was a significant positive moderate correlation of self-efficacy with emotional eating. There was a significant negative moderate correlation between quality of life and emotional eating, but no significant correlation between A1C and emotional eating. As a result of the study, it was found that self-efficacy and quality of life of adolescents with type 1 diabetes have an effect on emotional eating, while A1C values of adolescents have no effect on emotional eating. In future studies, it is recommended to add other factors that may affect the emotional eating behaviors of adolescents with diabetes and also to make different studies with a higher number of samples.

Feasibility and Acceptability of Physical Activity Monitoring as an Educational Tool in Management of Pediatric Type 1 Diabetes

ObjectivesThe spontaneous, sporadic and sometimes unpredictable nature of children's physical activity causes fluctuations in blood glucose level and challenges for children with type 1 diabetes. Physical activity monitoring has potential utility. In this study, we explored the perceptions of physical activity monitoring among health-care professionals and assessed the feasibility and acceptability of using it in the management of pediatric type 1 diabetes. MethodsSeven health-care professionals from 1 pediatric diabetes centre in the United Kingdom were involved in a focus group. Data were analyzed thematically. Physical activity monitoring using a wrist-worn monitor was tested for feasibility with 13 children aged 7 to 11 years with type 1 diabetes. The primary outcome was feasibility (i.e. recruitment, adherence, data completion, adverse events and acceptability). Secondary measures were glycemic control, parental self-efficacy for diabetes management and parental fear of hypoglycemia. ResultsHealth-care professionals valued having an awareness of the level, type and intensity of children’s physical activity. They identified unmet training and resource needs that would facilitate them in being able to give physical activity advice to children and families. Recruitment rate was 20%, adherence to the activity monitoring was good and the study completion rate was 62%. No adverse events were reported. Physical activity monitoring was considered acceptable by parents. ConclusionsPhysical activity monitoring could be a feasible part of routine clinical practice, but further research is needed to understand whether health-care professionals are best placed to implement it and what impact it has on health outcomes.

Diabetes conversation map - a novel tool for diabetes management self-efficacy among type 2 diabetes patients in Pakistan: a randomized controlled trial

BackgroundThis study aimed to measure the effect of diabetes education using the novel method of “diabetes conversation map (DCM)” as compared to routine counselling (RC) on diabetes management self-efficacy (DMSE) among patients living with type 2 diabetes in Karachi, Pakistan.MethodsA parallel arm randomized controlled trial among patients with type 2 diabetes aged 30–60 years, with HbA1c > 7%, diagnosed for at least 5 yrs., was conducted at the national institute of diabetes and endocrinology in Karachi, Pakistan. A total 123 type 2 diabetes patients were randomized into DCM (n = 62) or RC (n = 61). Four weekly diabetes control sessions of 40 min each using the DCM or RC was provided. DMSE was measured using a validated Urdu language DMSE tool at baseline and after three months of the randomization. Change in DMSE and HbA1c levels within groups (pre-post) and between the groups after 3 months of enrollment was compared.ResultsBaseline characteristics except HbA1c were similar between the two arms. After 3 months of enrollment, there was no change in the DMSE score in the RC arm however, significant increase in DMSE score was noted in the DCM arm (P = < 0.001). The average difference (95% confidence interval) in DMSE score between the DCM and RC arm was 33.7(27.3, 40.0; p = < 0.001) after 3 months of the enrollment. Difference in HbA1c within groups was not significant.ConclusionsDCM significantly improved DMSE among type 2 diabetes patients in a developing country setting like Pakistan. Healthcare workers caring for type 2 diabetes patients need to be trained on DCM to effectively utilize this novel tool for educating diabetes patients.Trial registrationThis trial was prospectively registered. ClinicalTrials.gov Identifier: NCT03747471. Date of registration: Nov 20. 2018.